Li H K, Ma W Z, Liao J
Zhonghua Nei Ke Za Zhi. 1989 Jan;28(1):18-21, 61.
In order to study the left ventricular diastolic events in cardiomyopathy, carotid pulse tracing, electrocardiogram, phonocardiogram and apexcardiogram with its first derivatives (dA/dt) were simultaneously recorded in 240 normal subjects, 30 patients with dilated cardiomyopathy (DCM) and 44 patients with hypertrophic cardiomyopathy (HCM). Total relaxation time (TRT), total relaxation time index (TRTI), the ratio of A wave to total diastolic amplitude in apexcardiogram (A/D), diastolic amplitude time index (DATI), the ratio of RF wave in apexcardiogram to the total amplitude of apex tracing (F/H) and the variables reflecting the diastolic properties were measured to evaluate the left ventricular relaxation and compliance. Meanwhile, two variables reflecting the contractile ability of the left ventricle were measured in order to compare with the diastolic events. The results demonstrated that in normal subjects relaxation and compliance of the left ventricle showed a tendency of natural "decay" with aging and in patients with DCM and HCM these were significantly decreased, especially in patients with HCM. A/D, which reflects the left ventricular compliance, was increased in patients with HCM as compared with normal subjects (P less than 0.01) and also with patients with DCM. It means that a greater A/D is in favor of the diagnosis of HCM rather than DCM. In addition to abnormal diastolic events, systolic dysfunction, as evidenced by remarkable abnormalities of the contractile variables (PEP/LVET and R-dA/dt.I), was found as well in patients with DCM.
为研究心肌病患者的左心室舒张事件,对240名正常受试者、30例扩张型心肌病(DCM)患者和44例肥厚型心肌病(HCM)患者同时记录了颈动脉脉搏描记图、心电图、心音图和心尖搏动图及其一阶导数(dA/dt)。测量总舒张时间(TRT)、总舒张时间指数(TRTI)、心尖搏动图中A波与总舒张振幅之比(A/D)、舒张振幅时间指数(DATI)、心尖搏动图中RF波与心尖搏动总振幅之比(F/H)以及反映舒张特性的变量,以评估左心室舒张功能和顺应性。同时,测量反映左心室收缩能力的两个变量,以便与舒张事件进行比较。结果表明,正常受试者左心室舒张功能和顺应性随年龄增长呈自然“衰减”趋势,而DCM和HCM患者的这些指标显著降低,尤其是HCM患者。反映左心室顺应性的A/D在HCM患者中较正常受试者升高(P<0.01),与DCM患者相比也升高。这意味着较高的A/D更有利于HCM而非DCM的诊断。除舒张事件异常外,DCM患者还存在收缩功能障碍,表现为收缩变量(PEP/LVET和R-dA/dt.I)明显异常。